2008—2021年湖北省手足口病病原学及流行病学分析  

Etiological and epidemiological characteristics of hand,foot and mouth diseases in Hubei Province from 2008 to 2021

作　　者：陈娟 梁颖 程唯佳 李宁[2] 刘娜[2] 伍仕敏 王雷[2] CHEN Juan;LIANG Ying;CHENG Weijia;LI Ning;LIU Na;WU Shimin;WANG Lei(Center for Clinical Laboratory,General Hospital of The Yangtze River Shipping&Wuhan Brain Hospital,Wuhan 430014,Hubei,China;Hubei Provincial Center for Disease Control and Prevention,Wuhan 430079,Hubei,China)

机构地区：[1]长江航运总医院/武汉脑科医院检验科,湖北武汉430010 [2]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《武汉大学学报（医学版）》2023年第12期1516-1523,共8页Medical Journal of Wuhan University

基　　金：武汉市卫生计生科研基金项目(编号:WX21C02)。

摘　　要：目的:了解2008—2021年湖北省手足口病的病原学及流行病学特征,为湖北省手足口病的防控提供科学依据。方法:通过中国疾病预防控制信息系统和湖北省儿童免疫规划信息管理系统获取手足口病病例信息、EV71疫苗接种数据,并进行病原学和流行病学分析。结果:2008—2021年湖北省累计报告手足口病981050例,年均报告发病率为120.80/10万,累计报告重症病例1667例,重症占比为0.17%;死亡病例112例,病死率为0.01%,年均死亡率为0.05/10万。发病年龄主要分布在5岁以下儿童,占病例总数的95.28%;男女性别比为1.56∶1;患者以散居儿童和幼托儿童为主,分别占报告病例总数的67.32%和29.06%。发病曲线除2020年(受新型冠状病毒感染疫情影响)呈单峰分布外,其余年份呈双峰分布,春夏高峰为4~6月,秋冬高峰为10~12月;病原学特征上,湖北省的优势流行株一直为EV71亚型;湖北省发病率居前5位的地区分别为神农架林区(303.95/10万)、黄石市(204.62/10万)、襄阳市(197.17/10万)、鄂州市(182.83/10万)、十堰市(159.23/10万);2016—2021年湖北省EV71疫苗平均接种率为18.45%。结论:湖北省HFMD呈现出明显的季节、人群以及地区分布特征,自2008年以来EV71型一直都是流行优势株,散居儿童和幼托儿童为高危人群。为有效预防HFMD,需大力推广EV71疫苗的接种以提高人群覆盖率,同时加强疫情监测、病原分型尤其是流行优势株基因型及重组分析。Objective:To analyze the etiological and epidemiological characteristics of hand⁃foot⁃mouth dis⁃ease(HFMD)from 2008 to 2021 in Hubei Province,China,and to provide a scientific basis for the prevention and control of HFMD.Methods:The information on HFMD cases and enterovirus 71(EV71)vaccine data were obtained from the Chinese Disease Prevention and Control Information System and the Children Immunization Program Information Management System of Hubei,and the etio⁃logical and epidemiological analyses were conducted.Results:A total of 981050 cases were reported in Hubei Province from 2008 to 2021 including 1667 severe cases and 112 deaths,with an average an⁃nual incidence of 120.80/100000.The severe cases rate and deaths rate were 0.17%and 0.01%re⁃spectively,and the annual mortality rate was 0.05/100000.Cases in children≤5 years old account⁃ed for 95.28%.The male⁃to⁃female ratio was 1.56∶1.The scattered children and kindergarten chil⁃dren accounted for 67.32%and 29.06%.The two incidence peaks were observed every year except for 2020(maybe affected by the COVID⁃19 epidemic),one was between April and June in spring and summer,and another was between October and December in autumn and winter.On the whole,EV71 was the dominant strain in Hubei Province from 2008 to 2021.The top five areas with the high⁃est incidence in Hubei province were Shennongjia Forest(303.95/100000),Huangshi(204.62/100000),Xiangyang(197.17/100000),Ezhou(182.83/100000),and Shiyan(159.23/100000).The average vaccination rate of EV71 vaccine was 18.45%from 2008 to 2021.Conclusion:HFMD in Hubei Province shows obvious seasonal,population,and regional distribution characteristics.Since 2008,EV71 has been the dominant strain,and scattered children and kindergarten children were high⁃risk groups.To effectively prevent HFMD,it is necessary to promote the vaccination of EV71,and strengthen epidemic surveillance,especially monitoring the genotypes and recombinants of dominant strains.

关 键 词：手足口病 病原学 流行病学 EV71疫苗 

分 类 号：R183[医药卫生—流行病学]